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Vaginal microbiota and gynecological cancers: a complex and evolving relationship
No full textThe vagina hosts a community of microorganisms known as the vaginal microbiota. This community is relatively stable and straightforward, with Lactobacillus species being the most dominant members. The vaginal microbiota has various functions that are essential for maintaining human health and balance. For example, it can metabolise dietary nutrients, produce growth factors, communicate with other bacteria, modulate the immune system, and prevent the invasion of harmful pathogens. When the vaginal microbiota is disrupted, it can lead to diseases and infections. The observed disturbance is distinguished by a reduction in the prevalence of Lactobacillus and a concurrent rise in the number of other bacterial species that exhibit a higher tolerance to low oxygen levels. Gynecologic cancers are a group of cancers that affect the female reproductive organs and tissues, such as the ovaries, uterus, cervix, vagina, vulva, and endometrium. These cancers are a major global health problem for women. Understanding the complex interactions between the host and the vaginal microorganisms may provide new insights into the prevention and treatment of gynecologic cancers. This could improve the quality of life and health outcomes for women
Advances in skin gene therapy: utilizing innovative dressing scaffolds for wound healing, a comprehensive review
No full textThe skin, serving as the body's outermost layer, boasts a vast area and intricate structure, functioning as the primary barrier against external threats. Disruptions in the composition and functionality of the skin can lead to a diverse array of skin conditions, such as wounds, burns, and diabetic ulcers, along with inflammatory disorders, infections, and various types of skin cancer. These disorders not only exacerbate concerns regarding skin health and beauty but also have a significant impact on mental well-being. Due to the complexity of these disorders, conventional treatments often prove insufficient, necessitating the exploration of new therapeutic approaches. Researchers develop new therapies by deciphering these intricacies and gaining a thorough understanding of the protein networks and molecular processes in skin. A new window of opportunity has opened up for improving wound healing processes because of recent advancements in skin gene therapy. To enhance skin regeneration and healing, this extensive review investigates the use of novel dressing scaffolds in conjunction with gene therapy approaches. Scaffolds that do double duty as wound protectors and vectors for therapeutic gene delivery are being developed using innovative biomaterials. To improve cellular responses and speed healing, these state-of-the-art scaffolds allow for the targeted delivery and sustained release of genetic material. The most recent developments in gene therapy techniques include RNA interference, CRISPR-based gene editing, and the utilization of viral and non-viral vectors in conjunction with scaffolds, which were reviewed here to overcome skin disorders and wound complications. In the future, there will be rare chances to develop custom methods for skin health care thanks to the combination of modern technology and collaboration among discipline
Effect of manual cleaning system on urban pollution and litter management in developing areas
No full textLitter is an important challenge in urban management, which is affected by the efficiency of the cleaning system. In this study, the efficiency of manual cleaning system in litter collection was evaluated by Clean Environment Index (CEI) in three land-uses. The results showed that in the study area, the density of litter was in the range of 0.011–0.736 number/m2. The cigarette butt was the most observed litter (0.183/m2). On average, 17% of the observed litter were plastic. Based on calculated CEI, all commercial areas were in a dirty or extremely dirty status, which included 40% of all areas. However, residential and recreational areas were in clean and very clean status, respectively. The average CEI in commercial, residential, and recreational areas was 22.59, 3.69, and 0.413, respectively. Although the efficiency of manual cleaning was suitable for residential and recreational areas, the pollution status in commercial areas showed the low efficiency of the manual cleaning system. Using alternative methods for commercial areas can improve the litter management
Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
No full textBackground: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. Funding: Bill & Melinda Gates Foundatio
Wastewater surveillance of antibiotic resistance and class 1 integron-integrase genes: Potential impact of wastewater characteristics on genes profile
No full textAntibiotic resistance (AR) is a major global health concern, but current surveillance efforts primarily focus on healthcare settings, leaving a lack of understanding about AR across all sectors of the One Health approach. To bridge this gap, wastewater surveillance provides a cost-effective and efficient method for monitoring AR within a population. In this study, we implemented a surveillance program by monitoring the wastewater effluent from two large-scale municipal treatment plants situated in Isfahan, a central region of Iran. These treatment plants covered distinct catchment regions and served a combined population about two million of residents. Furthermore, the effect of physicochemical and microbial characteristics of wastewater effluent including biological oxygen demand (BOD), chemical oxygen demand (COD), total suspended solids (TSS), temperature, total coliforms and Escherichia coli concentration on the abundance of ARGs (blaCTX-M, tetW, sul1, cmlA, and ermB) and class 1 integron-integrase gene (intI1) were investigated. Sul1 and blaCTX-M were the most and least abundant ARGs in the two WWTPs, respectively. Principal Component Analysis showed that in both of the WWTPs all ARGs and intI1 gene abundance were positively correlated with effluent temperature, but all other effluent characteristics (BOD, COD, TSS, total coliforms and E. coli) showed no significant correlation with ARGs abundance. Temperature could affect the performance of conventional activated sludge process, which in turn could affect the abundance of ARGs. The results of this study suggest that other factors than BOD, COD and TSS may affect the ARGs abundance. The predicted AR could lead to development of effective interventions and policies to combat AR in the clinical settings. However, further research is needed to determine the relationship between the AR in wastewater and clinical settings as well as the effect of other influential factors on ARGs abundance
A systematic review of serological and surgical cases of human hydatid cysts between 2003 and 2023 in Fars province, southern Iran
No full textOne of the most common methods to observe the indicators of hydatid cyst disease in human societies is to check the annual occurrence rate of confirmed cases in health centers or cases that have undergone surgery. Kenny disease applied Cystic Echinococcosis (CE). The main goal of this study is to systematically review statistical data related to CE between 2003 and 2023 in Fars province, one of the most populated provinces in the southwest of Iran. The results show that the highest prevalence of serology and surgery in this province is related to the age group below 50 years. Among the 299 positive cases detected by ELISA in serology, the prevalence rate among men is 55.85 and 44.14 among women. In 905 surgical cases, 51.60 were men, and 48.4 were women. In general, the obtained results show no significant relationship between the genders of people, but there is a relationship between age and the prevalence of the disease. The changes in this disease during these 20 years have not fluctuated much, and from this point of view, better measures can be taken to control this disease. Teaching the life cycle and transmission methods of this parasitic disease to humans in human societies is very important in preventing this parasitic disease
Explaining the Reasons for Not Receiving the COVID-19 Vaccine during Pregnancy: A Qualitative Study
No full textBackground: During the outbreak of infectious diseases such as COVID-19, pregnant women and their fetuses among high-risk groups, and vaccination is one of the most effective ways to prevent some infectious diseas However, there is little information about the attitude of pregnant women, their husbands, and health serv providers regarding receiving COVID-19 immunization. Therefore, the purpose of the present study was to expl the reasons for not receiving the COVID-19 vaccine during pregnancy. Methods: The present research was conducted in the framework of a qualitative approach and with the meth of inductive content analysis in 2022. 29 participants including pregnant women, their spouses and, hea service providers were selected with purposeful sampling and a maximum diversity participant select strategy. The data collection tool was a semi-structured interview. Data analysis was done manually by Granheim and Lundman method. Findings: The data analysis led to the emergence of 367 codes, 10 subcategories, and 3 main categor ("Incorrect performance of the health system", " Attitudes, opinions, beliefs " and "fears and uncertainties"). Conclusion: Knowing the obstacles to vaccine injection helps implement effective interventions for opti immunization coverage. It will be possible to inform pregnant women with the cooperation and strong role midwives and gynecologists based on new and scientific documents and emphasizing the safety, effectivene efficiency, and role of the vaccine in reducing the mortality of pregnant mothers and even neonates until acceptance of vaccination in similar crises will increase among pregnant women as one of the most dangero groups in the society
National and subnational burden of mental disorders in Iran (1990–2019): findings of the Global Burden of Disease 2019 study
No full textBackground Mental and behavioural disorders account for a large proportion of the burden of diseases in Iran. Identifying the pattern of change can help in policy making and provision of mental health services. We aimed to analyse the burden of mental disorders (excluding substance use disorders) in Iran at national and subnational levels with data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019.
Methods We used data from 1990 to 2019 on anxiety disorders, attention-deficit hyperactivity disorder, autism spectrum disorders, bipolar disorder, conduct disorder, depressive disorders, eating disorders, idiopathic developmental intellectual disability, schizophrenia, and other mental disorders in Iran and its 31 provinces. We calculated total disability-adjusted life-years (DALYs), age-standardised DALYs, and prevalence rates in 1990 and 2019, as well as the percentage change between these time periods.
Findings Mental disorders accounted for 1 159 410 (4.6%) of 25 007 732 all-cause DALYs in Iran in 1990 and 2 053 871 (10.3%) of 19 828 721 in 2019. Although total DALYs for mental disorders increased by 77.1% (95% uncertainty interval 76.7 to 77.6%) during this period, age-standardised DALY rate increased by 1.8% (-4.1 to 7.7%). The overall patterns of change were similar at the subnational level as the national level, although the rates differed between provinces with a highest-to-lowest ratio of 1.22 for age-standardised DALY rates in 2019.
Interpretation The increase in the burden of mental disorders in Iran is higher than the general trend in the world. The slight change in age-standardised DALYs suggests that the increase is mainly attributable to changes in the size and structure of the population. Considering the absolute and relative increase in the burden of mental disorders during the past 30 years at national and provincial levels, there is an urgent need to address the determinants of mental health and upgrade mental health services across all levels of care in Iran. Copyright (c) 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
General and abdominal adiposity and hypertension in eight world regions: a pooled analysis of 837 population-based studies with 7·5 million participants
No full textBackground Adiposity can be measured using BMI (which is based on weight and height) as well as indices of abdominal adiposity. We examined the association between BMI and waist-to-height ratio (WHtR) within and across populations of different world regions and quantified how well these two metrics discriminate between people with and without hypertension. Methods We used data from studies carried out from 1990 to 2023 on BMI, WHtR and hypertension in people aged 20-64 years in representative samples of the general population in eight world regions. We graphically compared the regional distributions of BMI and WHtR, and calculated Pearson's correlation coefficients between BMI and WHtR within each region. We used mixed-effects linear regression to estimate the extent to which WHtR varies across regions at the same BMI. We graphically examined the prevalence of hypertension and the distribution of people who have hypertension both in relation to BMI and WHtR, and we assessed how closely BMI and WHtR discriminate between participants with and without hypertension using C-statistic and net reclassification improvement (NRI). Findings The correlation between BMI and WHtR ranged from 076 to 089 within different regions. After adjusting for age and BMI, mean WHtR was highest in south Asia for both sexes, followed by Latin America and the Caribbean and the region of central Asia, Middle East and north Africa. Mean WHtR was lowest in central and eastern Europe for both sexes, in the high-income western region for women, and in Oceania for men. Conversely, to achieve an equivalent WHtR, the BMI of the population of south Asia would need to be, on average, 2 center dot 79 kg/m(2) (95% CI 231-328) lower for women and 1 center dot 28 kg/m(2) (1<02-154) lower for men than in the high-income western region. In every region, hypertension prevalence increased with both BMI and WHtR. Models with either of these two adiposity metrics had virtually identical C-statistics and NRIs for every region and sex, with C-statistics ranging from 0<72 to 081 and NRIs ranging from 034 to 0 center dot 57 in different region and sex combinations. When both BMI and WHtR were used, performance improved only slightly compared with using either adiposity measure alone. Interpretation BMI can distinguish young and middle-aged adults with higher versus lower amounts of abdominal adiposity with moderate-to-high accuracy, and both BMI and WHtR distinguish people with or without hypertension. However, at the same BMI level, people in south Asia, Latin America and the Caribbean, and the region of central Asia, Middle East and north Africa, have higher WHtR than in the other regions
Dexamethasone in COVID-19 treatment: Analyzing monotherapy and combination therapy approaches
No full textThe COVID-19 pandemic has prompted the exploration of effective treatment options, with dexamethasone emerging as a key corticosteroid for severe cases. This review evaluates the efficacy and safety of dexamethasone, highlighting its ability to reduce mortality rates, alleviate acute respiratory distress syndrome (ARDS), and mitigate hyperinflammation. While dexamethasone shows therapeutic promise, potential adverse effects-including cardiovascular issues, neuropsychiatric complications, lung infections, and liver damage-necessitate careful monitoring and individualized treatment strategies. The review also addresses the debate over using dexamethasone alone versus in combination with other therapies targeting SARS-CoV-2, examining potential synergistic effects and drug resistance. In summary, dexamethasone is a valuable treatment option for COVID-19 but its risks highlight the need for tailored surveillance approaches. Further research is essential to establish clear guidelines for optimizing treatment and improving patient outcomes